This topic is about the challenges and considerations involved in repairing a parastomal hernia, which is a common issue for people with a stoma. The person sharing their experience is 66 years old and has a colostomy due to emergency surgery. They are dealing with a mild parastomal hernia and a protruding stoma, which are more of a cosmetic concern than a functional one. They are seeking advice and real-world experiences from others who have undergone hernia repair. Here are some insights and advice gathered from the discussion:

1. Choose the right surgeon:
- Look for colorectal or general surgeons who specialize in parastomal hernias and have a track record of low recurrence rates. It's important to interview at least two surgeons.
- Build a good relationship with your surgeon and ensure they discuss the surgical technique, type of mesh, number of cases they've handled, expected recovery, complication rates, and their experience with revising stomas during the same procedure.
- Specialized centers, like the Cleveland Clinic Foundation, often provide the best outcomes.

2. Timing and progression:
- Many people stress that repairing the hernia is easier when it's small. If left untreated, it can enlarge, complicating surgery or causing obstructions.
- If the hernia is already causing blockages, surgery becomes necessary rather than just cosmetic.

3. Surgical techniques and materials:
- Successful examples include stoma relocation into the rectus muscle with porcine mesh, Sugarbaker laparoscopic repair, and open repair with conversion from loop to end colostomy.
- There are debates about mesh types; some surgeons avoid synthetic mesh due to infection risks, while others have had success with biologic mesh like porcine.

4. Expected outcomes and lifestyle changes:
- Good results are often reported when heavy lifting is limited after surgery. A permanent change in lifting habits is recommended.
- A flat stoma can occur after mesh placement, possibly due to the mesh acting as a rigid barrier.

5. Belt and non-surgical management:
- Wearing a Nu-Hope hernia belt full-time can help control the bulge and reduce the risk of obstruction.
- Some people find that daily Miralax helps with intermittent blockages.

6. Personal decision factors:
- Consider your personal healing history and overall health. If you heal poorly, you might want to reconsider surgery.
- Weigh the psychosocial benefits, like improved body image and better-fitting clothes, against the risks of surgery, hospital stay, and potential recurrence.
- Age alone should not deter you from repair; several people in their mid-60s have reported successful outcomes.

7. Practical tips for consultations:
- Bring a written list of questions to your consultations, including questions about the surgical route, possibility of combined revision, mesh choice, and closure method.
- Clarify how the "size" of the hernia is measured, whether by CT scan or physical exam.
- Ensure that surgeons are prepared to adapt during surgery if unexpected issues arise.

Products mentioned include Hollister large-capacity colostomy pouches, Nu-Hope support/hernia belts, and Miralax laxative.